Yom Kippur Sermon 5770
Rabbi Kim Ettlinger
September 29, 2009

Mental Illness

Boker tov, good morning, and may you have an Easy Fast!

Do you remember a time, long time ago, back in the shtetl, or around your grandparent's dinner table when people would whisper the names of different diseases and illnesses? No one, 40 or more years ago suffered from cancer, people suffered from cancer (whisper), no one even 20 years ago had AIDS, they had (whisper) aids. We whispered medical conditions because saying them aloud made them real, meant that you could catch it. No matter how irrational it was, people on golf courses, around mahjongg tables, whispered the illness of loved ones.

Today, there is still one illness whispered in our community. An estimated 26 percent of Americans, about 60 million souls, or one in four live with this terrible affliction we call Mental Illness.

Mental illness ranges from Autism and Turrette's syndrome, to ADD and ADHD to phobias, to Alzheimer's disease to bipolar disorder, borderline personality disorder, schizophrenia, psychotic breaks and severe depression.

Without a second thought, we are all guilty of calling others crazy, or insane, psycho, or schizo, without accurate discriminate between these labels. It's part of our society. If you head to Pier 39 and Fisherman's wharf you can even buy a $10 T-shirts that says something like "Alcatraz Outpatient Mental Ward."

Insane people fascinate us, they intrigue us; we are both curious and cautious at the same time, but from a distance. They make for interesting movie and TV characters such as Hannibal Lecter who rouses in us fear and excitement.

In reality, in real time, why does fear overtake our curiosity? With curiosity we make room for knowledge, for empathy, and to reach out. With fear our prejudices rise to the surface. Whether it is someone we meet on the street or someone who enters our place of work, or school, or synagogue, we greet them with an uneasy feeling. We tend to shy away, and not get too close. We don't know how to act. We see their immediate behavior rather than the soul and the person they are.

Understanding and openness can change the way we think about, and react to, our family members and friends who live with Mental Illness. It doesn't discriminate against race, socio-economic class, education etc.

Through education we teach our children to overcome prejudice and racism. Bigotry comes from ignorance. This is true for Mental Illness too.

Mental Illness affects the Jewish community. Jews also suffer from Mental Illness. Two years ago Dr. David Valle of Johns Hopkins University began studying the possible genetic link among Ashkenazi Jews for bipolar disorder and schizophrenia. He will complete the study in 2012.

Other illness, job stress, emotional shifts in one's family, and spiritual despair can all lead to anxiety that can trigger Mental Illness. Many of us have suffered from situational depression or sadness. This temporary depression maybe triggered by bereavement, work loss, or the economy, we also recognize post-partum depression in this realm. However, in the long term it doesn't prevent us from living life, getting up in the morning and going to work, from our daily activities, and we are able to keep things in perspective. However for many, it is more complicated and long term.

Our experience of other illnesses such as breast cancer and AIDS is that silence kills. Today, we speak up, we walk, we ride, and we unite to fight and raise awareness. "Friends and neighbors bring food when you have a broken leg or surgery. They don't when you have Mental Illness." [1] People with mental illness and their caregivers MUST speak up and we need to listen.

In this morning's Haftarah from the book of Isaiah, we will hear God say "Cry with a full throat, do not hold back, let your voice resound like a shofar: declare to My people their transgression..." [Isaiah 58:1]

The transgression is that we haven't been listening; we have not heard the call of the shofar. The Haftarah continues to say that we as Jews are chosen to "unlock the shackles of injustice, to loosen the ropes of the yoke, to let the oppressed go free and to never withdraw yourself from your own kin." We must not pull ourselves away, we must not abandon those in need.

Over the summer, I attended a one day seminar on Mental Illness. It was co-sponsored by Congregation Beth Sholom and the Bay Area Jewish Healing Center. [2] (Neal Tandowsky, a life-long member of PTS, is President of the Board of the Healing Center.) The National Alliance on Mental Illness, NAMI, was invited and present. I sat and heard panelists, patients, doctors, and family members.

One panelist said "I thought that what I was going through was typical teenage misery. Then in grad school I was feeling happy and confident for the first time, but, I wasn't sleeping, I wasn't eating, and I was talking to myself. I thought I was the reincarnation of the person that I was writing about in a research paper; that's when I knew that something was strange. The book An Unquiet Mind catapulted me to call my friend and seek help. Ten years later, I went back to grad school and became a doctor." Dr. Karin Tamerius who is a Dr. of Psychiatry at UCSF said these words and lives with Mental Illness every day.

I went to breakout groups listening to how the Jewish community and PTS can better listen to and provide services for our members who suffer from Mental Illness.
The day ended with a healing service, we stood in a circle, some clergy, but mostly family members of, as well as, people who suffer from this illness. We recited the blessing for healing, and we listened. We listened to our inner voice and the outer voice say that we are here to acknowledge and work towards helping people in our community with Mental Illness, that we are ready to help break down the stigma associated with Mental Illness.

This conference was on August 25, then a few days later we heard and saw on the news about another teen who committed suicide in Palo Alto. In four months, two girls and one boy died on the tracks, one other was saved and taken to hospital. A week later, the Headline of J - Newspaper read "Grappling with teen suicide: Religious leaders offer solace...." The J featured the August 31 community meeting in Palo Alto.

Depression and Mental Illness plagues our children. About 20% of children suffer from a Mental Illness that ranges from depression, to anxiety disorder, from eating disorders and neurological tics. We stereotype teens as moody or unsocial. One teen, Jean-Paul Blanchard z"l was described as an 'outgoing teen who loved kids and animals, earned decent grades, played on the tennis team and had a girlfriend.' [3] Not someone we may have expected. One of the teens, she was only 13.

Rabbi Janet Marder of Congregation Beth Am in Los Altos Hills remarked that teen suicide is not culture specific. [3] It happens in all communities and environments.

I have counseled families grappling with depression with their tween or teen. When a nine year old child talks about hurting him or herself because she feels an inner pain and can't explain it. Imagine a child who barely understands life feeling the need to die. WE have to stop and listen.

Mental Illness can affect anyone of us, a doctor, a teen, a grandparent, a CEO of a multi national corporation, a labourer, a rabbi. Let me share with you this story from the Talmud [4], written almost 1600 years ago, probably around the 4th Century of the Common Era.

The room was dark. Rabbi Eleazar was still in bed, turned toward the wall. He could not bring himself to look toward the window at life and light. Rabbi Yochanan entered the room, looked down through the darkness at his friend, pulled up a chair and sat down. Rabbi Yochanan prepared to sit in this heavy silence for a long time. He began to roll up his sleeve. His face reflected the darkness. But his hands and arms seemed to brighten the room with their own light. Rabbi Eleazar turned from the wall to face his friend.

Yochanan asked: "Why are you crying?"

Rabbi Eleazar was silent for another moment. Then he blinked at the brightness of Yochanan's white shirt. His gentle hands. The pale skin of his forearms.

Eleazar finally spoke. "I weep because all light fades into darkness. Because all beauty eventually rots."

After some time Rabbi Yochanan replied: "Yes, ultimately, everything dies. So perhaps, you have reason to weep."

They wept in darkness together.

Yochanan asked: "Does darkness comfort you?"

Slowly, Eleazar shook his head. "Maybe it did in the beginning, but it can't protect me from my thoughts."

Yochanan asked: "And the silence? Is it comforting?"

(Eleazer) "No."

(Yochanan) "And being alone?"

Eleazar looked into his friend's eyes. "No, loneliness adds to my suffering."

(Yochanan) "Do you continue to welcome this darkness, this silence, this sadness?"

(Eleazer) "No. Before I couldn't bear the light, noise, or laughter. Now I can no longer bear the alternatives. But I don't know the way back to the living."

Yochanan asked: "Will you let me help you?"

(Eleazer) "I will try."

Yochanan extended his hand. Eleazar grasped hold of it. He felt light and life touch him. He felt strength and warmth reach him. His friend Yochanan raised him out of his bed and helped him to the door.

Rabbi Paul Kipnes of Calabasas reminds us that the 'Talmudic rabbis did not use words like "depression" or "Mental Illness." Maybe it's better that way. Without technical labels to alarm us, we can listen with open minds. We hear the story.' [5]

What can we do? [6] Mental Illness is pervasive. And people who live with Mental Illness deserve the same honor and respect we show toward anyone else. As members of a community we have a responsibility to welcome everyone. We are obligated in the mitzvah of Bikkur Cholim, the responsibility to take care of people who are sick. No matter the diagnosis. And we must not forget those family members and friends - The caretakers who wear themselves out taking care of people who are sick. We are responsible for them too. [7]

On a simple level we can begin by not misusing terms such as schizo, nuts, wacko. Let's make talking about Mental Lllness easier and more comfortable.
We can fight for the same health insurance coverage for mental illnesses that physical diagnoses receive. No one would accept a limit on visits to the doctor for cancer or for a broken leg. Why should our nation accept any limits on health coverage for those people living with a diagnosable Mental Illness?

The best thing we can do is to become more of a supportive and welcoming community. PTS is already well known for its warmth, let's take this up a notch and extend it to those suffering with Mental Illness.

We can be a more supportive friend, Like Rabbi Yochanan we can lead our friend to the door. We can walk or drive a friend to a therapy session. We can be a shoulder to cry on and we can most importantly do something so very easy and that is to listen. Even if we are fearful and we don't understand and our hearts are breaking, we can still listen. We can be present.

Soon we will hear the Shema recited as part of the Torah Service, "Listen Israel, the Eternal One is God The Eternal is One." Let us listen to the cry of those who are silently at the doorways of our communities. Let us lift up our voice and ask to be heard within the center of our holiest places and call out for healing as individuals and as community. Let the Shema break down these walls that are built up by society and the ones erected around our hearts. [8]

Again, like Rabbi Yochanan, we are not expected to have the cure, but we are expected to be compassionate and caring.

Today, on tables outside the sanctuary, you will find a pamphlet titled "When Madness Comes Home along" with other resources including the yellow prayer card you received when entering the sanctuary this morning. And another sheet of resources. These resources will be posted on the PTS website. Know that your clergy are ever available to speak with you or help with resources for yourself or a loved one.

The High Holy Days call us to listen, to take action, to change our ways. And, we get to this point because the Jewish quest for understanding and meaning demands it of us. God demands it of us. God continues to tell us through Isaiah "Nachamu, nachamu, Ami, Comfort me, comfort me, my people! Let us not be deaf to the cry of those most in need.

Let us comfort each other, let us together, break down the stigma of mental illness and open our hearts, our minds, our hands and our souls.

May this be God's Will!
Amen and Amen.

Thank you to Rabbi Eric Weiss, Executive Director of the Bay Area Jewish Healing Center for his insight, wisdom and guidance on this sermon.

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Notes:

[1] Speaker at the Seminar on Mental Illness co sponsored by Congregation Beth Sholom and the Bay Area Jewish Healing Center on Aug 25, 2009 held at Congregation Beth Sholom in SF.

[2] Thank you to Rabbi Eric Weiss, Executive Director of the Bay Area Jewish Healing Center for his insight and wisdom and guidance on this sermon.

[3] J Newpaper, September 4, 2009 - Grappling with teen suicide.

[4] Babylonian Talmud, Brachot 5b. Adapted from a version told by Rabbi Susan Lippe in her sermon, A Jewish Response to Mental Illness.

[5] Rabbi Paul Kipnes in his Yom Kippur Sermon in October 2003, 5764 - Lifting the Veil of Silence: A Misheberach for Those Struggling with Mental Illness.

[6] Many of the suggestions here are from Rabbi Susan Lippe in her sermon, A Jewish Response to Mental Illness.

[7] Rabbi Susan Lippe in her sermon, A Jewish Response to Mental Illness.

[8] Inspired by Rabbi Elliot Kukla of the JBAHC in the Service she wrote with Rabbi Micah Hyman (Congregation Beth Sholom, SF) Nachamu, Nachamu Ami: A Service of Comfort and Healing.